Referral & Authorization Specialist - Care Lane Hematology/Oncology Clinic
About The Position
Glens Falls Hospital is hiring a Referral & Authorization Specialist for the Care Lane Hematology/Oncology Clinic. The role serves as a link between oncology patients, providers, and insurance payers, helping patients access cancer treatments while reducing insurance-related stress. It offers an opportunity to develop skills in medical billing, compliance, and Health Information Management (HIM). The specialist verifies insurance eligibility, obtains prior authorizations, counsels patients about coverage and financial obligations, supports clinic staff with authorization questions and workflows, follows up on denials, and assembles documentation needed for accurate submissions and compliance. Compensation is $18.50 to $27.76 per hour; the exact rate is determined case by case based on experience, education, and relevant certifications.
Requirements
- High school diploma or GED equivalent.
- Excellent computer proficiency.
- Exceptional customer service skills, multitasking ability, and strong verbal and written communication skills.
Nice To Haves
- Associate degree (AAS) in Health Administration, Business, Finance, or a related field.
- Four years of healthcare insurance experience is preferred; this experience can substitute for an Associate degree.
- Familiarity with medical terminology, CPT/ICD coding, and Medicare and third-party regulations.
- Fast and accurate typing; 60 words per minute preferred.
Responsibilities
- Verify patient insurance eligibility, review medical-necessity guidelines, and obtain prior authorizations from payers.
- Counsel patients about insurance benefits, financial obligations, and coverage questions.
- Serve as a central contact for clinic staff regarding authorizations; stay current on procedure guidelines and assist with monitoring patient waiting workflows when needed.
- Provide clinical staff with guidance on authorization rules and notify providers about insurance obstacles.
- Track ongoing referrals and lead follow-up on insurance denials to secure proper reimbursement.
- Compile medical records, clinical notes, and CPT/ICD coding information for accurate documentation and submissions.
Benefits
- The employer describes its benefits offerings as valuable and competitive. Benefits are available to active full-time and part-time employees who work at least 30 hours per week; specific benefits are not listed in the posting.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
